Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE

Facility

$561.60

Service Code	NDC 60687050401
Hospital Charge Code	11640
Hospital Revenue Code	637
Min. Negotiated Rate	$207.79
Max. Negotiated Rate	$561.60
Rate for Payer: Aetna Commercial	$505.44
Rate for Payer: Aetna Medicare	$207.79
Rate for Payer: ASR ASR	$544.75
Rate for Payer: BCBS Complete	$224.64
Rate for Payer: BCBS Trust/PPO	$463.04
Rate for Payer: BCN Commercial	$463.04
Rate for Payer: Cash Price	$449.28
Rate for Payer: Cofinity Commercial	$527.90
Rate for Payer: Encore Health Key Benefits Commercial	$449.28
Rate for Payer: Healthscope Commercial	$544.75
Rate for Payer: Healthscope Whirlpool	$561.60
Rate for Payer: Mclaren Commercial	$505.44
Rate for Payer: MI Amish Medical Board Commercial	$449.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$477.36
Rate for Payer: Nomi Health Commercial	$460.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$421.20
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$492.07
Rate for Payer: Priority Health Narrow Network	$393.68
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$494.21

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE

Facility

$561.60

Service Code	NDC 60687050401
Hospital Charge Code	11640
Hospital Revenue Code	637
Min. Negotiated Rate	$421.20
Max. Negotiated Rate	$561.60
Rate for Payer: Aetna Commercial	$505.44
Rate for Payer: ASR ASR	$544.75
Rate for Payer: BCBS Trust/PPO	$461.19
Rate for Payer: BCN Commercial	$461.19
Rate for Payer: Cash Price	$449.28
Rate for Payer: Cofinity Commercial	$527.90
Rate for Payer: Encore Health Key Benefits Commercial	$449.28
Rate for Payer: Healthscope Commercial	$544.75
Rate for Payer: Healthscope Whirlpool	$561.60
Rate for Payer: Mclaren Commercial	$505.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$477.36
Rate for Payer: Nomi Health Commercial	$460.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$421.20
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$494.21

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE

Facility

$439.45

Service Code	NDC 68462029301
Hospital Charge Code	11640
Hospital Revenue Code	637
Min. Negotiated Rate	$329.59
Max. Negotiated Rate	$439.45
Rate for Payer: Aetna Commercial	$395.50
Rate for Payer: ASR ASR	$426.27
Rate for Payer: BCBS Trust/PPO	$360.88
Rate for Payer: BCN Commercial	$360.88
Rate for Payer: Cash Price	$351.56
Rate for Payer: Cofinity Commercial	$413.08
Rate for Payer: Encore Health Key Benefits Commercial	$351.56
Rate for Payer: Healthscope Commercial	$426.27
Rate for Payer: Healthscope Whirlpool	$439.45
Rate for Payer: Mclaren Commercial	$395.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$373.53
Rate for Payer: Nomi Health Commercial	$360.35
Rate for Payer: Opus (Opus Packaging Group) HMA	$329.59
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$386.72

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE

Facility

$5.62

Service Code	NDC 60687050411
Hospital Charge Code	11640
Hospital Revenue Code	637
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare	$2.08
Rate for Payer: ASR ASR	$5.45
Rate for Payer: BCBS Complete	$2.25
Rate for Payer: BCBS Trust/PPO	$4.63
Rate for Payer: BCN Commercial	$4.63
Rate for Payer: Cash Price	$4.49
Rate for Payer: Cofinity Commercial	$5.28
Rate for Payer: Encore Health Key Benefits Commercial	$4.49
Rate for Payer: Healthscope Commercial	$5.45
Rate for Payer: Healthscope Whirlpool	$5.62
Rate for Payer: Mclaren Commercial	$5.05
Rate for Payer: MI Amish Medical Board Commercial	$4.49
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.77
Rate for Payer: Nomi Health Commercial	$4.61
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.21
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$4.92
Rate for Payer: Priority Health Narrow Network	$3.94
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$4.94

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE

Facility

$5.62

Service Code	NDC 60687050411
Hospital Charge Code	11640
Hospital Revenue Code	637
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: ASR ASR	$5.45
Rate for Payer: BCBS Trust/PPO	$4.61
Rate for Payer: BCN Commercial	$4.61
Rate for Payer: Cash Price	$4.49
Rate for Payer: Cofinity Commercial	$5.28
Rate for Payer: Encore Health Key Benefits Commercial	$4.49
Rate for Payer: Healthscope Commercial	$5.45
Rate for Payer: Healthscope Whirlpool	$5.62
Rate for Payer: Mclaren Commercial	$5.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.77
Rate for Payer: Nomi Health Commercial	$4.61
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.21
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$4.94

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE

Facility

$439.45

Service Code	NDC 68462029301
Hospital Charge Code	11640
Hospital Revenue Code	637
Min. Negotiated Rate	$162.60
Max. Negotiated Rate	$439.45
Rate for Payer: Aetna Commercial	$395.50
Rate for Payer: Aetna Medicare	$162.60
Rate for Payer: ASR ASR	$426.27
Rate for Payer: BCBS Complete	$175.78
Rate for Payer: BCBS Trust/PPO	$362.33
Rate for Payer: BCN Commercial	$362.33
Rate for Payer: Cash Price	$351.56
Rate for Payer: Cofinity Commercial	$413.08
Rate for Payer: Encore Health Key Benefits Commercial	$351.56
Rate for Payer: Healthscope Commercial	$426.27
Rate for Payer: Healthscope Whirlpool	$439.45
Rate for Payer: Mclaren Commercial	$395.50
Rate for Payer: MI Amish Medical Board Commercial	$351.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$373.53
Rate for Payer: Nomi Health Commercial	$360.35
Rate for Payer: Opus (Opus Packaging Group) HMA	$329.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$385.05
Rate for Payer: Priority Health Narrow Network	$308.05
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$386.72

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$26,798.46

Service Code	APR-DRG 3104
Min. Negotiated Rate	$24,229.02
Max. Negotiated Rate	$26,798.46
Rate for Payer: BCBS Complete	$26,798.46
Rate for Payer: Mclaren Medicaid	$25,522.34
Rate for Payer: Meridian Medicaid	$26,798.46
Rate for Payer: PHP Medicaid	$24,229.02
Rate for Payer: Priority Health Choice Medicaid	$25,522.34
Rate for Payer: UHC Medicaid	$25,522.34
Rate for Payer: UHCCP Medicaid	$25,522.34

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$19,503.76

Service Code	APR-DRG 3103
Min. Negotiated Rate	$17,633.73
Max. Negotiated Rate	$19,503.76
Rate for Payer: BCBS Complete	$19,503.76
Rate for Payer: Mclaren Medicaid	$18,575.01
Rate for Payer: Meridian Medicaid	$19,503.76
Rate for Payer: PHP Medicaid	$17,633.73
Rate for Payer: Priority Health Choice Medicaid	$18,575.01
Rate for Payer: UHC Medicaid	$18,575.01
Rate for Payer: UHCCP Medicaid	$18,575.01

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$12,282.63

Service Code	APR-DRG 3102
Min. Negotiated Rate	$11,104.97
Max. Negotiated Rate	$12,282.63
Rate for Payer: BCBS Complete	$12,282.63
Rate for Payer: Mclaren Medicaid	$11,697.74
Rate for Payer: Meridian Medicaid	$12,282.63
Rate for Payer: PHP Medicaid	$11,104.97
Rate for Payer: Priority Health Choice Medicaid	$11,697.74
Rate for Payer: UHC Medicaid	$11,697.74
Rate for Payer: UHCCP Medicaid	$11,697.74

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$8,214.03

Service Code	APR-DRG 3101
Min. Negotiated Rate	$7,426.47
Max. Negotiated Rate	$8,214.03
Rate for Payer: BCBS Complete	$8,214.03
Rate for Payer: Mclaren Medicaid	$7,822.89
Rate for Payer: Meridian Medicaid	$8,214.03
Rate for Payer: PHP Medicaid	$7,426.47
Rate for Payer: Priority Health Choice Medicaid	$7,822.89
Rate for Payer: UHC Medicaid	$7,822.89
Rate for Payer: UHCCP Medicaid	$7,822.89

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$4,558.51

Service Code	APR-DRG 1112
Min. Negotiated Rate	$4,121.44
Max. Negotiated Rate	$4,558.51
Rate for Payer: BCBS Complete	$4,558.51
Rate for Payer: Mclaren Medicaid	$4,341.44
Rate for Payer: Meridian Medicaid	$4,558.51
Rate for Payer: PHP Medicaid	$4,121.44
Rate for Payer: Priority Health Choice Medicaid	$4,341.44
Rate for Payer: UHC Medicaid	$4,341.44
Rate for Payer: UHCCP Medicaid	$4,341.44

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$8,515.93

Service Code	APR-DRG 1114
Min. Negotiated Rate	$7,699.42
Max. Negotiated Rate	$8,515.93
Rate for Payer: BCBS Complete	$8,515.93
Rate for Payer: Mclaren Medicaid	$8,110.41
Rate for Payer: Meridian Medicaid	$8,515.93
Rate for Payer: PHP Medicaid	$7,699.42
Rate for Payer: Priority Health Choice Medicaid	$8,110.41
Rate for Payer: UHC Medicaid	$8,110.41
Rate for Payer: UHCCP Medicaid	$8,110.41

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$3,946.53

Service Code	APR-DRG 1111
Min. Negotiated Rate	$3,568.13
Max. Negotiated Rate	$3,946.53
Rate for Payer: BCBS Complete	$3,946.53
Rate for Payer: Mclaren Medicaid	$3,758.60
Rate for Payer: Meridian Medicaid	$3,946.53
Rate for Payer: PHP Medicaid	$3,568.13
Rate for Payer: Priority Health Choice Medicaid	$3,758.60
Rate for Payer: UHC Medicaid	$3,758.60
Rate for Payer: UHCCP Medicaid	$3,758.60

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$5,662.03

Service Code	APR-DRG 1113
Min. Negotiated Rate	$5,119.15
Max. Negotiated Rate	$5,662.03
Rate for Payer: BCBS Complete	$5,662.03
Rate for Payer: Mclaren Medicaid	$5,392.41
Rate for Payer: Meridian Medicaid	$5,662.03
Rate for Payer: PHP Medicaid	$5,119.15
Rate for Payer: Priority Health Choice Medicaid	$5,392.41
Rate for Payer: UHC Medicaid	$5,392.41
Rate for Payer: UHCCP Medicaid	$5,392.41

VILAZODONE 20 MG TABLET

Facility

$527.03

Service Code	NDC 60505477303
Hospital Charge Code	152700
Hospital Revenue Code	637
Min. Negotiated Rate	$395.27
Max. Negotiated Rate	$527.03
Rate for Payer: Aetna Commercial	$474.33
Rate for Payer: ASR ASR	$511.22
Rate for Payer: BCBS Trust/PPO	$432.80
Rate for Payer: BCN Commercial	$432.80
Rate for Payer: Cash Price	$421.62
Rate for Payer: Cofinity Commercial	$495.41
Rate for Payer: Encore Health Key Benefits Commercial	$421.62
Rate for Payer: Healthscope Commercial	$511.22
Rate for Payer: Healthscope Whirlpool	$527.03
Rate for Payer: Mclaren Commercial	$474.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$447.97
Rate for Payer: Nomi Health Commercial	$432.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$395.27
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$463.78

VILAZODONE 20 MG TABLET

Facility

$1,317.46

Service Code	NDC 456112030
Hospital Charge Code	152700
Hospital Revenue Code	637
Min. Negotiated Rate	$487.46
Max. Negotiated Rate	$1,317.46
Rate for Payer: Aetna Commercial	$1,185.71
Rate for Payer: Aetna Medicare	$487.46
Rate for Payer: ASR ASR	$1,277.94
Rate for Payer: BCBS Complete	$526.98
Rate for Payer: BCBS Trust/PPO	$1,086.24
Rate for Payer: BCN Commercial	$1,086.24
Rate for Payer: Cash Price	$1,053.97
Rate for Payer: Cofinity Commercial	$1,238.41
Rate for Payer: Encore Health Key Benefits Commercial	$1,053.97
Rate for Payer: Healthscope Commercial	$1,277.94
Rate for Payer: Healthscope Whirlpool	$1,317.46
Rate for Payer: Mclaren Commercial	$1,185.71
Rate for Payer: MI Amish Medical Board Commercial	$1,053.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,119.84
Rate for Payer: Nomi Health Commercial	$1,080.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$988.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$1,154.36
Rate for Payer: Priority Health Narrow Network	$923.54
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$1,159.36

VILAZODONE 20 MG TABLET

Facility

$1,317.46

Service Code	NDC 456112030
Hospital Charge Code	152700
Hospital Revenue Code	637
Min. Negotiated Rate	$988.09
Max. Negotiated Rate	$1,317.46
Rate for Payer: Aetna Commercial	$1,185.71
Rate for Payer: ASR ASR	$1,277.94
Rate for Payer: BCBS Trust/PPO	$1,081.90
Rate for Payer: BCN Commercial	$1,081.90
Rate for Payer: Cash Price	$1,053.97
Rate for Payer: Cofinity Commercial	$1,238.41
Rate for Payer: Encore Health Key Benefits Commercial	$1,053.97
Rate for Payer: Healthscope Commercial	$1,277.94
Rate for Payer: Healthscope Whirlpool	$1,317.46
Rate for Payer: Mclaren Commercial	$1,185.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,119.84
Rate for Payer: Nomi Health Commercial	$1,080.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$988.09
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$1,159.36

VILAZODONE 20 MG TABLET

Facility

$527.03

Service Code	NDC 60505477303
Hospital Charge Code	152700
Hospital Revenue Code	637
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$527.03
Rate for Payer: Aetna Commercial	$474.33
Rate for Payer: Aetna Medicare	$195.00
Rate for Payer: ASR ASR	$511.22
Rate for Payer: BCBS Complete	$210.81
Rate for Payer: BCBS Trust/PPO	$434.53
Rate for Payer: BCN Commercial	$434.53
Rate for Payer: Cash Price	$421.62
Rate for Payer: Cofinity Commercial	$495.41
Rate for Payer: Encore Health Key Benefits Commercial	$421.62
Rate for Payer: Healthscope Commercial	$511.22
Rate for Payer: Healthscope Whirlpool	$527.03
Rate for Payer: Mclaren Commercial	$474.33
Rate for Payer: MI Amish Medical Board Commercial	$421.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$447.97
Rate for Payer: Nomi Health Commercial	$432.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$395.27
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$461.78
Rate for Payer: Priority Health Narrow Network	$369.45
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$463.78

VILAZODONE 20 MG TABLET

Facility

$166.18

Service Code	NDC 60505437303
Hospital Charge Code	152700
Hospital Revenue Code	637
Min. Negotiated Rate	$61.49
Max. Negotiated Rate	$166.18
Rate for Payer: Aetna Commercial	$149.56
Rate for Payer: Aetna Medicare	$61.49
Rate for Payer: ASR ASR	$161.19
Rate for Payer: BCBS Complete	$66.47
Rate for Payer: BCBS Trust/PPO	$137.01
Rate for Payer: BCN Commercial	$137.01
Rate for Payer: Cash Price	$132.94
Rate for Payer: Cofinity Commercial	$156.21
Rate for Payer: Encore Health Key Benefits Commercial	$132.94
Rate for Payer: Healthscope Commercial	$161.19
Rate for Payer: Healthscope Whirlpool	$166.18
Rate for Payer: Mclaren Commercial	$149.56
Rate for Payer: MI Amish Medical Board Commercial	$132.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$141.25
Rate for Payer: Nomi Health Commercial	$136.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$124.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$145.60
Rate for Payer: Priority Health Narrow Network	$116.49
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$146.23

VILAZODONE 20 MG TABLET

Facility

$166.18

Service Code	NDC 60505437303
Hospital Charge Code	152700
Hospital Revenue Code	637
Min. Negotiated Rate	$124.63
Max. Negotiated Rate	$166.18
Rate for Payer: Aetna Commercial	$149.56
Rate for Payer: ASR ASR	$161.19
Rate for Payer: BCBS Trust/PPO	$136.46
Rate for Payer: BCN Commercial	$136.46
Rate for Payer: Cash Price	$132.94
Rate for Payer: Cofinity Commercial	$156.21
Rate for Payer: Encore Health Key Benefits Commercial	$132.94
Rate for Payer: Healthscope Commercial	$161.19
Rate for Payer: Healthscope Whirlpool	$166.18
Rate for Payer: Mclaren Commercial	$149.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$141.25
Rate for Payer: Nomi Health Commercial	$136.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$124.63
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$146.23

VILAZODONE 40 MG TABLET

Facility

$542.24

Service Code	NDC 62332023430
Hospital Charge Code	152701
Hospital Revenue Code	637
Min. Negotiated Rate	$200.63
Max. Negotiated Rate	$542.24
Rate for Payer: Aetna Commercial	$488.01
Rate for Payer: Aetna Medicare	$200.63
Rate for Payer: ASR ASR	$525.97
Rate for Payer: BCBS Complete	$216.89
Rate for Payer: BCBS Trust/PPO	$447.07
Rate for Payer: BCN Commercial	$447.07
Rate for Payer: Cash Price	$433.79
Rate for Payer: Cofinity Commercial	$509.70
Rate for Payer: Encore Health Key Benefits Commercial	$433.79
Rate for Payer: Healthscope Commercial	$525.97
Rate for Payer: Healthscope Whirlpool	$542.24
Rate for Payer: Mclaren Commercial	$488.01
Rate for Payer: MI Amish Medical Board Commercial	$433.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$460.90
Rate for Payer: Nomi Health Commercial	$444.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$406.68
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$475.11
Rate for Payer: Priority Health Narrow Network	$380.11
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$477.17

VILAZODONE 40 MG TABLET

Facility

$542.24

Service Code	NDC 62332023430
Hospital Charge Code	152701
Hospital Revenue Code	637
Min. Negotiated Rate	$406.68
Max. Negotiated Rate	$542.24
Rate for Payer: Aetna Commercial	$488.01
Rate for Payer: ASR ASR	$525.97
Rate for Payer: BCBS Trust/PPO	$445.28
Rate for Payer: BCN Commercial	$445.28
Rate for Payer: Cash Price	$433.79
Rate for Payer: Cofinity Commercial	$509.70
Rate for Payer: Encore Health Key Benefits Commercial	$433.79
Rate for Payer: Healthscope Commercial	$525.97
Rate for Payer: Healthscope Whirlpool	$542.24
Rate for Payer: Mclaren Commercial	$488.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$460.90
Rate for Payer: Nomi Health Commercial	$444.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$406.68
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$477.17

VIRAL ILLNESS

Facility

$8,118.67

Service Code	APR-DRG 7234
Min. Negotiated Rate	$7,340.24
Max. Negotiated Rate	$8,118.67
Rate for Payer: BCBS Complete	$8,118.67
Rate for Payer: Mclaren Medicaid	$7,732.06
Rate for Payer: Meridian Medicaid	$8,118.67
Rate for Payer: PHP Medicaid	$7,340.24
Rate for Payer: Priority Health Choice Medicaid	$7,732.06
Rate for Payer: UHC Medicaid	$7,732.06
Rate for Payer: UHCCP Medicaid	$7,732.06

VIRAL ILLNESS

Facility

$3,228.83

Service Code	APR-DRG 7232
Min. Negotiated Rate	$2,919.25
Max. Negotiated Rate	$3,228.83
Rate for Payer: BCBS Complete	$3,228.83
Rate for Payer: Mclaren Medicaid	$3,075.07
Rate for Payer: Meridian Medicaid	$3,228.83
Rate for Payer: PHP Medicaid	$2,919.25
Rate for Payer: Priority Health Choice Medicaid	$3,075.07
Rate for Payer: UHC Medicaid	$3,075.07
Rate for Payer: UHCCP Medicaid	$3,075.07

VIRAL ILLNESS

Facility

$5,700.18

Service Code	APR-DRG 7233
Min. Negotiated Rate	$5,153.64
Max. Negotiated Rate	$5,700.18
Rate for Payer: BCBS Complete	$5,700.18
Rate for Payer: Mclaren Medicaid	$5,428.74
Rate for Payer: Meridian Medicaid	$5,700.18
Rate for Payer: PHP Medicaid	$5,153.64
Rate for Payer: Priority Health Choice Medicaid	$5,428.74
Rate for Payer: UHC Medicaid	$5,428.74
Rate for Payer: UHCCP Medicaid	$5,428.74

Know your out-of-pocket cost for care.

All Charges